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Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
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[Overcoming therapy resistance in prolactinomas: from perspectives to real clinical practice]

A S Shutova1, E A Pigarova1, L I Lepeshkina2

  • 1Endocrinology Research Centre.

Problemy Endokrinologii
|February 5, 2024
PubMed

Insights

Dopamine agonist therapy is standard for prolactin-secreting pituitary adenomas, but resistance occurs in 20% of patients. Combined treatment with tamoxifen and dopamine agonists effectively managed a resistant microprolactinoma case.

Area of Science:

  • Endocrinology
  • Oncology

Context:

  • Prolactin-secreting pituitary adenomas are typically treated with dopamine agonists.
  • Approximately 20% of patients exhibit resistance to dopamine agonist therapy, leading to persistent hyperprolactinemia.

Purpose:

  • To present a clinical case of dopamine-agonist resistant microprolactinoma.
  • To highlight the potential of combined therapy for managing treatment resistance.

Summary:

  • A patient with dopamine-agonist resistant microprolactinoma achieved stabilized health, normalized prolactin levels, and reduced adenoma size.
  • This was accomplished through a combination of tamoxifen and dopamine agonists.

Impact:

  • Effective management of therapy resistance is crucial for preventing irreversible changes and improving patient quality of life.
  • Identifying causes and predictors of resistance is important for developing personalized treatment algorithms for hyperprolactinemia.

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